Organization
KEYSTONE INTERNAL MEDICINE AND WEIGHT LOSS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POLLYTIA IRENE PANAGIOTOU MD (MEDICAL DIRECTOR)
(201) 447-3690
Entity
Organization
Contact information
Practice address
255 WEST SPRING VALLEY AVE, SECOND FLOOR, SUITE 200, MAYWOOD, NJ 07607
(201) 447-3690
Mailing address
PO BOX 1461, RIDGEWOOD, NJ 07451-1461
(201) 450-6044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/02/2019
Last updated
06/27/2019
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